Comparative efficacy of traditional Chinese medicine-based non-pharmacological therapies for managing cancer-related fatigue in lung cancer patients: a systematic review and network meta-analysis.

BACKGROUND: Fatigue is a prevalent symptom in lung cancer patients and adversely affects their health and quality of life. While some evidence suggests that Traditional Chinese Medicine (TCM)-based non-pharmacological therapies can effectively alleviate cancer-related fatigue (CRF), it remains unclear which therapy is most effective for managing CRF in this population. OBJECTIVE: To compare the effects of different TCM-based non-pharmacological therapies on reducing CRF in lung cancer patients. METHODS: We searched eight databases from their inception to 24 November 2025. Following literature screening, the quality of the included randomized controlled trials (RCTs) was assessed using the Cochrane Risk of Bias 2.0 tool. A network meta-analysis was conducted to evaluate the relative efficacy of the TCM-based non-pharmacological therapies. Statistical analyses were performed using STATA 18.0 software. RESULTS: A total of 32 RCTs involving eight TCM-based non-pharmacological therapies were included. The network meta-analysis results indicated that moxibustion (SMD = -2.56, 95% CI = -3.60 to -1.51) and auricular acupressure (SMD = -1.82, 95% CI = -3.61 to -0.03) were significantly more effective than usual care in improving CRF. Furthermore, moxibustion showed a significant advantage over qigong (SMD = -2.12, 95% CI = -3.58 to -0.65). CONCLUSION: Current evidence shows that moxibustion and auricular acupressure may be the most promising TCM-based non-pharmacological therapies for alleviating CRF in lung cancer patients, whereas qigong appears less effective. However, given the considerable risk of bias across the included studies, these conclusions require further validation through more rigorously designed, high-quality clinical trials.